机构：[1]Department of Otolaryngology–Head and Neck Surgery, National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, China四川大学华西医院[2]Medical Biophysics, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada[3]Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, Canada[4]Department of Economic Statistics, School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, China[5]Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany[6]Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada[7]Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada[8]Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada[9]Department of Laboratory Medicine and Pathology, University Health Network, University of Toronto, Toronto, Canada[10]Prosserman Centre for Population Health Research, Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, Canada[11]Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
In epidemiologic studies, patients with head and neck squamous cell carcinoma (HNSCC) are classified mainly by the International Classification of Diseases (ICD) codes. However, some patients are of an unclear subsite, the "gray zone" cases, which could reflect ICD coding error, absence of primary subsite, or extensive primary tumors that cross over multiple subsites of the oral cavity and oropharynx. Patients with gray zone squamous cell carcinomas were compared with patients with oral cavity squamous cell carcinoma (OSCC) or oropharyngeal squamous cell carcinoma (OPSCC) and stratified by human papillomavirus (HPV) status that was determined by p16 immunostaining or HPV serology. Comparisons consisted of clinicodemographic features and prognostic outcomes presented by Kaplan-Meier curves and Cox proportional hazards regression models, reported as hazard ratios. There were 158 consecutive patients with gray zone HNSCC diagnosed at the Princess Margaret Cancer Center between 2006 and 2017: 66 had subsite coding discrepancies against the clinician's documentation ("discrepant" cases; e.g., the diagnosis by the clinician was OSCC, while the classification by ICD coding was OPSCC), while 92 were squamous cell carcinoma of unknown primary of the head and neck (SCCUPHN) after complete diagnostic workup. Comparators included 721 consecutive OSCC and 938 OPSCC adult cases. All HPV-positive cohorts (OPSCC, discrepant, and SCCUPHN) had similar clinicodemographic characteristics and better 3- and 5-y overall survival and disease-free survival than their HPV-negative counterparts. In contrast, HPV-negative discrepant cases had prognostic outcomes most similar to HPV-negative OPSCC cases, while HPV-negative SCCUPHN had survival outcomes most similar to those of patients with OSCC in this study. HPV-positive status can improve the classification of patients with unclear or discrepant oral/oropharyngeal subsite, an improvement over classification systems that are solely clinician defined or conducted through ICD coding. However, due to clinical practice, we could not make definitive reclassification for patients with HPV-negative gray zone HNSCC.
基金：
the Princess Margaret Cancer Centre
Head and Neck Cancer Translational Research Program, which is
funded by the Wharton family, Joe’s Team, Gordon Tozer, Bruce
Galloway, and the Elia family. G. Liu was supported by thePosluns Family Fund and the Alan B. Brown Chair in Molecular
Genomics. J. Ren was supported by the Fundamental Research
Funds for the Central Universities (China; No. 2012017yjsy118).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2019]版：
大类|1 区医学
小类|1 区牙科与口腔外科
最新[2023]版：
大类|1 区医学
小类|1 区牙科与口腔外科
第一作者：
第一作者机构：[1]Department of Otolaryngology–Head and Neck Surgery, National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, China[2]Medical Biophysics, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
共同第一作者：
通讯作者：
通讯机构：[2]Medical Biophysics, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada[5]Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany[8]Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada[11]Dalla Lana School of Public Health, University of Toronto, Toronto, Canada[*1]Princess Margaret Cancer Centre–University Health Network, University of Toronto, 610 University Ave, Toronto, Canada, ON M5G 2M9[*2]Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 242, 69126 Heidelberg, Germany.
推荐引用方式(GB/T 7714)：
J. Ren,W. Xu,J. Su,et al.HPV Status Improves Classification of Head and Neck Gray Zone Cancers.[J].Journal of dental research.2019,98(8):879-887.doi:10.1177/0022034519853771.
APA：
J. Ren,W. Xu,J. Su,X. Ren,N. Bender...&G. Liu.(2019).HPV Status Improves Classification of Head and Neck Gray Zone Cancers..Journal of dental research,98,(8)
MLA：
J. Ren,et al."HPV Status Improves Classification of Head and Neck Gray Zone Cancers.".Journal of dental research 98..8(2019):879-887
医学